Areas of Interest in Dental Education: A Bibliometric Analysis of the Last Decade.

This study aimed to perform a comprehensive bibliometric analysis of journals focused on dental education (Journal of Dental Education and European Journal of Dental Education) from 2014 to 2023. An ISI Web of Science Search was performed in October 2023 with no filters for language or keywords. Published articles between 2014 and 2018, 2019 and 2023, and 2014-2023, along with the top 100 cited articles published within this period were exported as txt files. Keyword and title word network maps and occurrences were generated using VOS Viewer software. Author-affiliated countries with the most publications were tabulated from the Web of Science. Dental education and dental students and education were consistently in the top six keywords and title word occurrences in all periods and top 100 cited articles. Similar trends were observed for keyword and title word network maps with an emphasis on dental education and students. However, the 2019-2023 period saw the emergence of coronavirus disease 2019, three-dimensional printing, virtual reality, and education technology, with the earlier period (2014-2018) showing clusters around students, perceptions, dental hygiene education, and assessment. The United States ranked top of the list for most published author-affiliated countries, with England, Canada, Australia, and Saudi Arabia in the top six for all periods analyzed. In conclusion, within the limitations of this study, areas of interest in dental education journals in the last decade were identified along with the countries with most publications.

Effectiveness of spaced repetition learning using a mobile flashcard application among dental students: A randomized controlled trial.

BACKGROUND: Dental education in India predominantly relies on traditional lecture-based learning (LBL), which may hinder student engagement and learning outcomes. To address these limitations, innovative learning methodologies, such as spaced repetition learning (SRL), are imperative. SRL prioritizes active recall and can enhance long-term knowledge retention. This study aims to assess the effectiveness of SRL delivered through a mobile flashcard application, in enhancing knowledge retention among dental undergraduates. METHODS: This single-blind randomized controlled trial (CTRI/2023/10/059347), conducted in Belagavi, India, involved 90 dental students who were equally distributed into control (LBL) and test (lecture followed by SRL demonstration) groups after randomization. Rigorous expert review ensured the quality of PowerPoint presentation and mobile flashcard contents. Knowledge assessments were conducted at baseline, first, and third months using a validated and reliable questionnaire. A perception survey on learning techniques was administered after the first month. Analysis methods included descriptive analysis, Pearson's chi-square test, independent t-test, and repeated measures ANOVA with Bonferroni's post hoc test. RESULTS: The pre- and post-intervention knowledge showed no significant differences, but the SRL group exhibited significantly higher retention at both first month (p ≤ 0.001) and third months (p ≤ 0.001) than the LBL group. Repeated measures ANOVA revealed significant pairwise differences in mean knowledge scores in SRL group. Students had significantly favorable perception toward SRL than LBL group. CONCLUSION: SRL delivered through mobile flashcards significantly enhances knowledge retention compared to LBL among dental students. Positive student perceptions support SRL's integration into dental curricula, with implications for improving knowledge retention among them.

Ethical issues in dental education-A cross-sectional study with pre-clinical and clinical dental students.

INTRODUCTION: Although ethics is an indispensable part of dental education, it has not yet played a relevant role in the dental curriculum in Germany. The study aimed at assessing their prior knowledge of ethical aspects, and their expectations of and wishes for ethics course of dental students, preclinical vs. clinical, at the dental school Kiel, Germany by means of a validated questionnaire. METHODS: A descriptive cross-sectional study design was used. The study population consisted of dental students, from pre-clinical (n = 105) and clinical semesters (n = 110). In January 2019, each student completed a validated questionnaire to identify semester-specific ethical teaching content. Besides descriptive analyses, Mann-Whitney U test was used to compare pre-clinical and clinical students. RESULTS: A total of 215 dental students, with a mean age of 25.3 (SD 4.1), participated in the study, of which 150 were female (69.8%) and 65 were male students (30.2%). The results in the areas of 'previous knowledge of ethical issues' and 'expectations and desires in terms of teaching medical ethics' showed similarities and differences between pre-clinical and clinical students. Both groups stated that they need training in ethics. Moreover, especially clinical students recognize that more ethical competence is needed if the first patient contact will start. CONCLUSION: The study indicates that there is a clear need for ethics education. Student awareness of the relevance of ethical competences and the perception of ethical problems increased progressively during the course of their studies. Overall, the study provides good support for the development of specific ethics courses.

A morphology-based integrated teaching mode combining pathology and radiology with the aid of teaching media: A randomized controlled trial.

OBJECTIVE: The integration of curriculum is an important approach for enhancing medical education and facilitating interdisciplinary connections among students. This study aimed to develop a new morphological integrated teaching mode for undergraduate stomatology education by combining stomatological pathology and radiology courses with instructional media. METHODS: In total, 63 undergraduates were included in this study and divided into three groups: traditional (Group T; the control group) and two experimental groups: KoPa WiFi EDU (Group K), and KoPa WiFi EDU-cone beam computed tomography (CBCT) (Group K-C). All participants attended a 2-h lecture on periapical cysts and completed the first theoretical test. Subsequently, they underwent a 4-h experimental training session on the pathology and radiology of periapical cysts using different teaching methods. Following the training, participants completed the second theoretical test and underwent the first image-reading skill evaluation. After a 3-month period, participants completed the third theoretical test and underwent the second image-reading skill evaluation. The effectiveness of the teaching methods was assessed by analyzing the differences in theoretical test and experimental skill evaluation scores. RESULTS: There were no significant differences in the first theoretical outcomes among three groups (p > 0.05). However, the second theoretical scores, the first objective evaluation scores, and the first subjective evaluation scores were significantly higher in the integrated teaching mode (3D teaching mode with the KoPa WiFi EDU and CBCT: 89.29 ± 4.55, 81.00 ± 8.15, and 61.57 ± 5.52, respectively; 2D teaching mode with the KoPa WiFi EDU system: 80.43 ± 3.41, 73.00 ± 8.01, and 55.67 ± 5.66, respectively) than in the traditional teaching mode (72.57 ± 3.84, 69.38 ± 4.91, and 48.67 ± 5.54, respectively) (p < 0.05). Moreover, the long-term teaching effect of the integrated mode was better than that of the traditional mode (p < 0.05). CONCLUSIONS: The morphology-based integrated teaching mode combining pathology and radiology aroused student enthusiasm for learning, and resulted in enhanced learning outcomes in dental experimental education.

Contemporary educational methods in periodontology.

AIM: The 1st European Workshop on Periodontal Education in 2009 made recommendations regarding the scope of periodontal education at undergraduate (UG), postgraduate (PG) and continuing professional development (CPD) levels, defining competencies and learning outcomes that were instrumental at the time in helping to define periodontal teaching curricula. The 19th European Workshop on Periodontology and 2nd European Consensus Workshop on Education in Periodontology (Education in Periodontology in Europe) was held in 2023 to identify changes and future developments in periodontal education (including those informed by the COVID-19 pandemic) and embracing methods and formats of periodontal teaching and training. The aim of this review was to assess current knowledge regarding education methods in periodontology, including traditional face-to-face (F2F) teaching and the move to student-centred methods, virtual learning methods and use of digital technology, as well as blended teaching and learning (including teaching delivery and assessment) at UG, PG and CPD levels. MATERIALS AND METHODS: Systematic searches were conducted to identify relevant studies from the literature. Data were extracted and descriptive summaries collated. RESULTS: The pandemic was a major disruptor of traditional F2F teaching but provided opportunities for rapid implementation of alternative and supplementary teaching methods. Although online learning has become an integral part of periodontal education, teachers and learners alike favour some form of F2F teaching. Blended teaching and learning are feasible in many areas of periodontal education, both for knowledge and skills acquisition as well as in assessment. Student-centred methods and blended approaches such as the flipped classroom seem highly effective, and online/virtual classrooms with both synchronous and asynchronous lectures are highly valued. Learning with haptic methods and virtual reality (VR) enhances the educational experience, especially when VR is integrated with traditional methods. The quality of the teacher continues to be decisive for the best knowledge transfer in all its forms. CONCLUSIONS: Live F2F teaching continues to be highly trusted; however, all types of student-centred and interactive forms of knowledge transfer are embraced as enhancements. While digital methods offer innovation in education, blended approaches integrating both virtual and traditional methods appear optimal to maximize the achievement of learning outcomes. All areas of periodontal education (UG, PG and CPD) can benefit from such approaches; however, more research is needed to evaluate their benefits, both for knowledge transfer and skills development, as well as in assessment.

Community-based dental education in Iranian dental schools.

BACKGROUND: Community-based dental education (CBDE) has been an essential advancement in dental education in recent decades, enhancing it in many aspects. This study aimed to determine the characteristics and improvements of CBDE in dental schools in Iran. METHODS: In the present descriptive study, an electronic questionnaire, including 18 "yes/no", "multiple choice", and "short answer" questions about the nature and extent of CBDE and students' experience in CBDE, was used. In early 2021, the questionnaires were mailed to the deans of all 43 dental schools in Iran under the supervision of the Council for Dental Education of the Iranian Ministry of Health and Medical Education. Reminder calls were made after 6 and 12 weeks. Dental schools that did not follow the CBDE program were excluded. The responses were analyzed descriptively. RESULTS: Thirty-six dental schools completed the questionnaire (response rate: 84%). Seventeen schools (47%) reported having CBDE in their dental program. Sites lacking a well-equipped dental setting were the most used out of all extramural sites. The number of weeks dedicated to CBDE ranged between 1 and 20 (median: 4). The most common dental procedures practiced in extramural sites were pediatric dentistry (100%), restorative dentistry (71%), and dental examination (59%). The student-to-supervisor ratio in CBDE ranged between 3 and 15 (median: 5). In most schools (65%), the staff involved in directing CBDE were Community Oral Health PhDs. CONCLUSIONS: An increasing number of Iranian dental schools have integrated CBDE into their undergraduate dental curriculum. The characteristics and extent of this educational strategy vary widely among dental schools. CBDE can be more effective by making positive changes in dental programs.

Exploring the Quality of Life (QOL) of medical students in Karachi, Pakistan.

BACKGROUND: The pursuit of medical and dental education is challenging and can affect the overall quality of life of medical students. Assessing the quality of life of medical students is the first step in the preparation of efficient future health care professionals. This study used the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) to evaluate the quality of life of medical and dental students in Karachi, Pakistan. OBJECTIVES: The study objectives include: assessing the QoL of medical and dental students and their general health satisfaction and self-satisfaction. MATERIALS AND METHODS: This cross-sectional study was conducted among 344 medical and dental students from different medical and dental schools in Karachi, Pakistan. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was used to assess QOL, which included 26 items covering four domains: physical, psychological, social, and environmental. All scores for the domains ranged from 4 to 20. Scoring was done according to the WHOQOL-BREF procedure manual. The questionnaire was disseminated to medical students using Google Forms. SPSS software was used to analyze the data. Cronbach's alpha and the Kaiser-Meyer-Olkin (KMO) test were used to evaluate the reliability and sampling adequacy of the data for factor analysis. Descriptive statistics were computed for each variable and QoL domain, including frequencies, percentages, averages, and standard deviations. Domain scores were compared using a t-test and one-way ANOVA, with p-values less than 0.05, indicating statistical significance. RESULTS: Among the 344 medical students, 56.7% (n = 195) were female and 43.3% (n = 149) were male. The WHOQOL-BREF demonstrated excellent reliability, with a Cronbach's alpha of 0.918. Most medical students rated their overall QOL (62.2%) and health satisfaction (46.8%) as good, and were able to get around well (71.3%). No significant sex differences were found across the various QOL domains. Marital status significantly affected QOL scores (p < 0.005). Single students had significantly higher QOL scores than married/separated/divorced students did. Overall, the environmental domain had the highest mean score (26.81 ± 6.17), while social relationships had the lowest mean score (9.68 ± 2.93). CONCLUSION: The findings of this study provide valuable insights into the QoL of medical and dental students. Most participants reported moderate satisfaction with their physical health and lower satisfaction with the psychological, social, and environmental components of QoL. Marital status was found to significantly impact the QoL as compared to single students with greater QoL. These findings can help form targeted interventions to enhance medical students' quality of life and prepare efficient future healthcare professionals.

Evaluating the difference in perception of the Akinosi technique among dentistry students: A comparison between theoretical and practical learning.

INTRODUCTION: Effective pain control is crucial in dental practice; thus, local anesthetic techniques have been extensively taught. The Halstead technique is the most commonly used inferior alveolar nerve block despite its relatively high failure rate. On the other hand, the Vazirani‒Akinosi technique (VAT) is less commonly taught. This study evaluated changes in final-year students' perceptions of VAT after a period of active learning. METHODS: This prospective randomized study was performed in 2022 and included fifth-year dental students (n = 91). The study group (n = 49) received practical VAT training during oral surgery internships, whereas the control group (n = 42) did not. A Likert-scale questionnaire assessed students' perceptions, theoretical knowledge, and difficulty levels. An independent sample t-test was used for comparison and the statistical significance level was set at p < 0.05. RESULTS: The survey response rate was 100%. Statistical analysis revealed significant differences between the groups for seven of the 12 questionnaire statements (p < 0.05). Overall, perception scores favored the study group, indicating a more positive response. The statements related to theoretical knowledge, except for one statement, showed no significant differences (p > 0.05). CONCLUSION: Practical training significantly improved students' perceptions of VAT, demonstrating the importance of active learning in dental education. Faculties should integrate active learning methods to enhance students' clinical skills and prepare them for professional practice.

Assessing the Utility of Oral and Maxillofacial Surgery Posters as Educational Aids in Dental Education for Undergraduate Students: Is it Useless or Helpful?

Background: Educational posters play a crucial role in education, information dissemination, and awareness. Their visual appeal efficiently communicates condensed yet vital information on significant topics, making them valuable for teaching sequential concepts. We aimed to assess the effectiveness of educational posters in the oral and maxillofacial surgery department for student education. Methods: The study was carried out during the fall semester of 2022 at Mashhad Dental School, Mashhad, Iran utilizing a questionnaire-based approach. The questionnaire gathered demographic information and assessed students' perspectives on educational posters. Statistical analysis was performed using SPSS version 23 with a significance level set at 0.05. Results: This study was conducted on 70 students (35 females and 35 males). Gender-based analysis demonstrated significant differences in beauty, adaptability, and learning, with male students scoring lower than females (P values = 0.036 and 0.031, respectively). Further analysis by academic year unveiled higher beauty and adaptability scores among third-year students compared to second-year students, showing statistical significance (P value = 0.035). A two-by-two comparison highlighted that the average beauty score of third and fifth-year students surpassed that of second-year students (P values = 0.041 and 0.038, respectively). In summary, higher academic years correlated with superior performance, emphasizing the potential impact of educational posters on academic outcomes. Conclusion: Posters in the oral and maxillofacial surgery department received commendable ratings in various areas, positively impacting the teaching and learning process.

Expectancy from, and acceptance of augmented reality in dental education programs: A structural equation model.

OBJECTIVE: Dental schools need hands-on training and feedback. Augmented reality (AR) and virtual reality (VR) technologies enable remote work and training. Education programs only partially integrated these technologies. For better technology integration, infrastructure readiness, prior-knowledge readiness, expectations, and learner attitudes toward AR and VR technologies must be understood together. Thus, this study creates a structural equation model to understand how these factors affect dental students' technology use. METHODS: A correlational survey was done. Four questionnaires were sent to 755 dental students from three schools. These participants were convenience-sampled. Surveys were developed using validity tests like explanatory and confirmatory factor analyses, Cronbach's ɑ, and composite reliability. Ten primary research hypotheses are tested with path analysis. RESULTS: A total of 81.22% responded to the survey (755 out of 930). Positive AR attitude, expectancy, and acceptance were endogenous variables. Positive attitudes toward AR were significantly influenced by two exogenous variables: infrastructure readiness (B = 0.359, ß = 0.386, L = 0.305, U = 0.457, p = 0.002) and prior-knowledge readiness (B = -0.056, ß = 0.306, L = 0.305, U = 0.457, p = 0.002). Expectancy from AR was affected by infrastructure, prior knowledge, and positive and negative AR attitudes. Infrastructure, prior-knowledge readiness, and positive attitude toward AR had positive effects on expectancy from AR (B = 0.201, ß = 0.204, L = 0.140, U = 0.267, p = 0.002). Negative attitude had a negative impact (B = -0.056, ß = -0.054, L = 0.091, U = 0.182, p = 0.002). Another exogenous variable was AR acceptance, which was affected by infrastructure, prior-knowledge preparation, positive attitudes, and expectancy. Significant differences were found in infrastructure, prior-knowledge readiness, positive attitude toward AR, and expectancy from AR (B = 0.041, ß = 0.046, L = 0.026, U = 0.086, p = 0.054). CONCLUSION: Infrastructure and prior-knowledge readiness for AR significantly affect positive AR attitudes. Together, these three criteria boost AR's potential. Infrastructure readiness, prior-knowledge readiness, positive attitudes toward AR, and AR expectations all increase AR adoption. The study provides insights that can help instructional system designers, developers, dental education institutions, and program developers better integrate these technologies into dental education programs. Integration can improve dental students' hands-on experience and program performance by providing training options anywhere and anytime.

Factors associated with predoctoral and graduate dental students' intention to care for elderly patients: A cross-sectional study.

OBJECTIVES: Ageism among pre-doctoral and graduate dental students may reduce their propensity to provide dental treatment to elderly patients leading to substandard healthcare for this population. This study evaluated the impact of perceived ageism constructs and geriatric dentistry education on the intention of pre-doctoral and graduate students to provide dental care for elderly patients. METHODS: A questionnaire was applied to collect the data for this cross-sectional study from pre-doctoral students in their clinical years and graduate students in their internship year (N = 201). A total of 183 completed responses were received, and the response rate was 91%. Hierarchical regression analysis was performed to determine the incremental effects of perceived ageism constructs and geriatric dentistry education on the intention to provide dental care for elderly patients. RESULTS: Geriatric dental education (B = 0.328, t = 3.826, p < 0.001) and patients' low compliance (B = 0.503, t = 4.658, p < 0.001) were significantly positive predictors of pre-doctoral and graduate students' intentions to care for elderly patients. Also, negative attitudes toward the lives of elderly people have a substantial adverse effect on the intention of care for this population (B = -0.225, t = -2.206, p = 0.029). Cronbach's alpha for the scale constructs ranged from 0.738 to 0.886. CONCLUSIONS: Advanced geriatric training may cultivate pre-doctoral and graduate students' deeper understanding and recognition of the intellectual and practical benefits that might arise from offering dental care to elderly people.

Clinical Experience Comparison of Foreign-Trained Dentists and Domestic Dental Students: One Institution's Experience.

This study compared the clinical experiences of foreign-trained dentists (FTDs) enrolled in an Advance Standing DMD Dental Program (DMDAS) with those of the domestic dental students (DMD) at the University of Illinois Chicago, College of Dentistry (UIC-COD). A cross-sectional retrospective chart review of patients treated by 295 DMD and 253 DMDAS predoctoral dental students was completed at the UIC-COD. The data were retrieved from the electronic health record system (axiUm) for the graduated classes of 2018, 2019, 2020, 2021, and 2022 on various performed clinical procedures as measured by relative value units (RVUs). The retrieved data were used to compare the clinical experiences of DMDAS vs. DMD students. Descriptive (mean) and statistical (independent t-test) analyses were used (α = 0.05). The results indicated that DMD and DMDAS students had comparable clinical experiences in several disciplines, including diagnosis, prevention, direct/indirect restorations, endodontics, periodontics, complete dentures, removable partial dentures, implants/fixed partial dentures, and oral surgery. There was a statistical difference in total RVUs for diagnosis (p = 0.002) and direct restorations (p < 0.001), in which DMD students had more experience. The 28 month program for FTDs appeared to be a reasonable timeframe to obtain an adequate number of varied clinical experiences as compared with the traditional four-year program at the UIC-COD.

Experiences of junior dental faculty transitioning from clinician to educator.

PURPOSE: Dental faculty enter academia, after a career in practice or directly from school, without any formal education training. Faculty development programs have been designed based on survey needs assessments, but not on in-depth descriptions of junior faculty transition experiences. The purpose of this research project is to describe the transition experiences of dental faculty from clinician to educator within the last 5 years. METHODS: A qualitative multiple case study approach from an emic perspective was used. An emic approach is an analysis from the perspective of one who participates in the group being studied. Data were collected through semi-structured interviews with 12 junior dental faculty. Thematic analysis identified common themes in the data through the lens of the social cognitive career theory. RESULTS: Three salient themes were extracted from the data: guidance, job satisfaction, and motivating factors. Guidance was the main theme with participants revealing their need for more formal preparation regarding teaching, formal mentorship, and career progression goals. Participants find academia highly rewarding, and a unique finding was that physical injury was a major factor to entering academia. CONCLUSION: This study reveals that junior dental faculty members feel unprepared for their teaching role and highlights the benefits of mentorship in helping them develop their vocational goals and advance their careers. This study illuminates why clinicians choose to leave clinical practice, the preparation they receive, the areas in which they feel unprepared, and how they develop their teaching skills. These insights can help academic institutions better support their faculty and improve student learning outcomes.

Enhanced personal protective equipment and dental students' experience and quality of a restorative procedure in a simulated clinical setting.

OBJECTIVES: To evaluate the effects of enhanced personal protective equipment (Enhanced_PPE) on student-operator's experience and restorative procedure. METHODS: Student-operators (N = 29 Year 3 dental students) performed Class II composite restorations (SimpliShade, Kerr) in typodont upper molars (OneDental) equipped with N95 respirators, full-face shields, disposable headwear and gowns (Enhanced_PPE) or surgical masks, protective glasses/goggles and non-disposable gowns (Standard_PPE) 2 weeks later. Cavity dimensions were measured on cone beam computed tomography images. The quality of composite restorations was assessed using selected FDI criteria and Vickers hardness. A questionnaire assessed the operators' discomfort, anxiety, confidence, ability to perform, and procedure outcome. Data were analyzed using paired t-test and McNemar test (alpha = 0.05). RESULTS: Student-operators experienced greater discomfort and anxiety, reduced confidence and ability to perform, and rated the procedure as less satisfactory with Enhanced_PPE (p < 0.05). Differences in proximal box width were marginally significant (Enhanced_PPE 1.8 ± 0.4 mm, Standard_PPE 1.6 ± 0.3 mm) (p = 0.047). Other cavity dimensions were similar between groups (p > 0.05) as were restorations regarding surface luster, anatomical form, marginal adaptation, proximal contour, and contact (p > 0.05). There were no differences in the hardness of composite restorations (top p = 0.349, bottom p = 0.334). CONCLUSIONS: Enhanced_PPE led to student-operator discomfort, anxiety, and reduced confidence, but did not impact the quality of Class II preparation and composite restorations versus Standard_PPE.

Awareness Levels About Specialty Services Offered by the Faculty of Dentistry in Sebha, Libya.

BACKGROUND: Assessment of awareness levels about any hospital is critical to judge its current standings and plan for future development. Limited literature is available about dental health in Libya. AIM: This study aimed to study the awareness and perception of the various specialty services offered by the Faculty of Dentistry (SDC), Sebha University for their quality and preference. MATERIALS AND METHODS: It was a performance monitoring research, and the data was collected by interview using a standardized questionnaire. Non-probability judgmental sampling was used. The offered services included all specialties in dentistry and oral cancer screening. Information relating to the awareness and perception of SDC specialty services was collected with few agree/disagree questions from 450 subjects. Data was collected, tabulated, and analyzed with descriptive statistics using SPSS v23.0 (IBM, Armonk, NY, USA). RESULTS: About 22.7% (n=102) were in the 45-54 years age group. Self-employed (n=108, 24%) and professional (n=108, 24%) were noted in occupation. Forty-eight (n=216) were graduates. Three hundred twenty-eight respondents (72.9%) were aware about the dental services. Four hundred twenty-eight respondents (95.1%) have visited SDC. Three hundred six respondents (68%) were satisfied, and 66 respondents (14.7%) were very much satisfied. Dental health checkups were predominantly known to the respondents (n=302, 67%). For all the other specialties, the awareness level was low. CONCLUSION: The identification of weak areas is crucial for the future planning and development of oral health care rendered by SDC.

Comparisons between referred and non-referred patients to a university paediatric dental clinic.

BACKGROUND: Referrals of paediatric patients to a university clinic have been increasing over the last several years. AIM: To evaluate characteristics of referred and non-referred patients at the University of Iowa's Pediatric Dental Clinic (UIPDC). DESIGN: A retrospective chart review included dental records of 340 referred and 383 non-referred patients from July 1, 2015, to May 31, 2016 (n = 723). Age, distance to the clinic, size of the patient's community, insurance, number of teeth with decay, treatment needs, educational level of the provider, and presence of patient special health care needs were obtained. Descriptive statistics, bivariate analysis, and multivariable logistic regression were performed to analyze the outcomes (alpha = .05). RESULTS: Referred patients were more likely to live >60 miles away, live in a community of >75 000 people, have special health care needs, have caries/greater number of teeth with decay, need endodontic treatment, and were less likely to remain patients at the clinic (p < .0001). Referred patients were also more likely to need extractions (p = .0104), but less likely to need space maintenance/comprehensive orthodontic treatment (p = .0002). CONCLUSION: There was a difference in the complexity of patient treatment needs between referred and non-referred patients.